DR. WYATT ISAAC WIEDENFELD (NPI# 1912310152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912310152 |
| Entity Type | Individual |
| Full Name | DR. WYATT ISAAC WIEDENFELD |
| Credential | DPM |
| Practice Address |
853 S Main St Oconto Falls WI 54154-1203 |
| Mailing Address |
853 S Main St Ste A Oconto Falls WI 54154-1212 |
| Practice Telephone | 9204964700 |
| Mailing Telephone | 9204964700 |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2019-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 5901002524 | MI | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16001 W 9 Mile Rd, Southfield, MI 480754818 | 2488493403 | |
| 26850 Providence Pkwy Ste 502, Novi, MI 483741267 | 2486624350 | |
| 29829 Telegraph Rd Ste 202, Southfield, MI 480347656 | 2482580001 | |
| 37595 7 Mile Rd Ste 370, Livonia, MI 481521003 | 2482580001 |
| Street Address |
853 S MAIN ST |
| City | OCONTO FALLS |
| State | WI |
| Zip Code | 54154-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700449741 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Clinic/Center | 853 S Main St, Oconto Falls, WI 54154-1203 | 2019-04-16 |
| 1750760740 | St. Vincent Hospital-hospital Sisters-third Order of St. Francis | Internal Medicine | 853 S Main St, Oconto Falls, WI 54154-1241 | 2015-05-22 |
| 1386037752 | Advanced Pain Management Sc | Durable Medical Equipment & Medical Supplies | 853 S Main St, Suite B100, Oconto Falls, WI 54154-1241 | 2015-03-10 |
| 1215325428 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Durable Medical Equipment & Medical Supplies | 853 S Main St, Oconto Falls, WI 54154-1241 | 2014-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578967220 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Clinic/Center | 853 South Main St, Suite A, Oconto Falls, WI 54154 | 2014-10-09 |
| 1194125534 | New Womens Care S C | Obstetrics & Gynecology | 855 South Main St., Oconto Falls, WI 54154 | 2014-09-03 |
| 1881869949 | Shari L Pfankuch | Occupational Therapist | 100 E Highland Drive, Sharpe Care, Oconto Falls, WI 54154 | 2008-04-29 |
| 1861666588 | Angela Irene Vancleve | Occupational Therapy Assistant | 100 E. Highland Drive, Oconto Falls, WI 54154 | 2008-04-14 |
| 1861793440 | Debra Kay Munes | Dentist | 248 North Main Street, Oconto Falls, WI 54154 | 2010-11-12 |
| 1194034850 | Forefront Dermatology, S.c. | Dermatology | 835 S Main St, Suite 1, Oconto Falls, WI 54154 | 2010-09-29 |
| 1851565774 | Marcy Ann Neitzer | Physical Therapy Assistant | 100 E Highland Dr, Oconto Falls, WI 54154 | 2008-04-22 |
| 1427168863 | Oconto Falls Dental Sc | Dentist | 248 N Main St, Oconto Falls, WI 54154 | 2006-08-30 |
| 1447235148 | David J Bell | Counselor | 107 E Highland Dr, Oconto Falls, WI 54154 | 2005-12-14 |
| 1306831052 | Heyde Health System Oconto Falls LLC | Skilled Nursing Facility | 100 E Highland Dr, Oconto Falls, WI 54154-1001 | 2005-09-19 |
| Find all providers in zip 54154 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161976 | Family Foot and Ankle Clinic LLC | Podiatrist | 1901 Westwood Boulevard, Wausau, WI 54401 | 2020-07-09 |
| 1588282453 | Family Foot and Ankle Clinic LLC | Podiatrist | 1021 Western Ave Ste C, Mosinee, WI 54455-1511 | 2020-07-08 |
| 1376161240 | Family Foot and Ankle Clinic LLC | Podiatrist | 1439 Churchill St Ste 202, Waupaca, WI 54981-2089 | 2020-07-08 |
| 1083237754 | Baycare Clinic LLP | Podiatrist | 630 Riverfront Dr, Sheboygan, WI 53081-4615 | 2020-05-28 |
| 1922637107 | Torhorst Foot and Ankle Clinic, Sc | Podiatrist | 2823 Post Rd, Stevens Point, WI 54481-6416 | 2020-04-08 |
| 1528446713 | Jonathan Shih | Podiatrist | 9200 W Loomis Rd Ste 116, Franklin, WI 53132 | 2015-05-08 |
| 1710397039 | Kristina Lorene Thompson | Podiatrist | 37868 Us-18, Prairie Du Chien, WI 53821 | 2014-05-08 |
| 1972856169 | Midwest Foot and Wound Care Center LLC | Podiatrist | W3853 Stoneridge Dr, Fond Du Lac, WI 54937-6201 | 2012-10-25 |
| 1073880936 | Tahir A Khan | Podiatrist | 6001 W Center St Ste 108, Milwaukee, WI 53210-2154 | 2011-11-21 |
| 1366724478 | Visiting Md Ltd | Podiatrist | 2426 N Grandview Blvd Ste D, Waukesha, WI 53188-6905 | 2011-09-14 |
| Find all providers with the same taxonomy | ||||
| City | OCONTO FALLS |
| Zip Code | 54154 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.